Sorry You Drug Me into This

When the Affordable Care Act (“Obamacare”) was passed in 2010, the Obama administration succumbed to pressure from the pharmaceutical lobby and kowtowed to pressure to keep Americans from legally accessing foreign markets, notably Canada and Western Europe, for vastly less-expensive prescriptions. Same medicines, different prices. The misplaced rational was an inability to assure Americans of the quality of their international purchases, even though it would have been a short step for the government to certify the standards of many countries as compliant with U.S. standards.

As a result, Americans pay the highest prices for prescription pharmaceuticals of any developed country on earth, sometimes incredible multiples of what foreigners in developed nations pay for the same products (many of which are actually fabricated overseas). To make matters worse, the pharma lobby made sure that the Act did not allow the healthcare exchanges created under that statute to use their size and buying power to force the purveyors of prescription drugs to negotiate lower prices for their consumers. They had to pay the posted prices without question.

Everyone knows how absolutely inane this effective subsidy to the big pharmas is, and their profit margins speak for themselves. They cry that they need such outrageous mark-up to support research for new drugs flies in the face that everywhere else in the developed world, these providers are living quite comfortably with significantly lower price points. Further, there is little rational for the United States’ subsidizing the global research market, when we only represent 5% of the earth’s total population.

As Congress begins to address this slam to the average American consumer, it is equally clear that congress-people – with their campaign funding hands constantly out, a factor made so much worse by the Citizens United decision – remain a soft touch to the pharma lobby. And trust me, it’s not just Republican legislators who are slopping at the pharma campaign funding trough, even though the GOP position is to stop this effort dead in its tracks.

“A group of House Democrats is organizing an effort that could slow down an Obama administration plan to reduce drug prices, according to a letter obtained by The Huffington Post.

“The Department of Health and Human Services is working toward finalizing a new rule that would experiment with ending the financial incentive doctors have for prescribing some extremely expensive medications. The rule has been well-received among some patient advocates, but congressional Democrats have been largely silent, while the pharmaceutical industry and medical community have waged an aggressive campaign to stop it.

“The campaign is bearing fruit. The letter from House Democrats, according to Drew Hammill, a spokesman for House Democratic Leader Nancy Pelosi (Calif.), was made necessary because Big Pharma and oncologist lobbyists had pushed many Democrats to the brink of signing a much more aggressive Republican letter. The letter expresses concerns with the proposed rule, but doesn’t call for it to be withdrawn.

“‘Members are outlining their concerns, but this letter is in furtherance of getting an effective rule in place under the current timeline. This in no way is an effort to slow down or undermine the administration’ s efforts,’ Hammill told HuffPost after this story published.

“On [April 27^th], Hammill said: ‘A number of members have expressed concern about the scope and size of this initiative while recognizing problems with current payment rules. Leader Pelosi hopes that CMS will continue to actively engage members and advocacy organizations as the particulars of this test are finalized.’… Hammill said Pelosi is urging members to sign the letter, which is being circulated by Rep. Richard Neal (D-Mass.).” Huffington Post, April 27^th.

Feeling impending significant price increases for Obamacare policies plus the intended withdrawal by United Healthcare from the relevant exchanges, the administration needs to find someplace to reduce healthcare costs in not just the Affordable Care Act but in Medicaid and Medicare as well.

“The Medicare drugs proposal is part of a larger push by the White House to tackle prescription drug costs, which are rising rapidly even as costs in other parts of the health care system have grown more slowly in recent years. The administration is limited in what it can do to ameliorate drug spending without new legislation, but convened a forum at the White House in November to air the issue and has issued a slate of smaller reforms.” Huffington Post.

Republican efforts to repeal the entirety of the Affordable Care Act, rather than simply fix its obvious flaws, has played very nicely into the hands of the special interests who have benefited by carefully-crafted clauses allowing them to maximize their profits… like big pharma. Historically, every piece of seminal social legislation, from income taxes to Social Security, has gone through a process of fine-tuning amendments, but not the Affordable Care Act. However, since just about everything in this country has tilted towards the will of the power elite, the fundamental essence of a plutocracy, it does seem that the will of the majority of the American people is a secondary afterthought. And we wonder why populism in both parties has risen to the level we are witnessing today.

I’m Peter Dekom, and either the playing field’s tilt will be leveled or we can watch this country self-destruct.